The URL can be used to link to this page

Home My WebLink AboutBLDE-19-003415 • a Commonwealth of Official Use Only IA Massachusetts Permit No. BLDE-19-003415 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:12/4/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomr the electrical work described below. Location(Street&Number) 35 SOUTH ST Owner or Tenant JOHNSON JACQUELYN Telephone No. Owner's Address 35 SOUTH ST,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No LI (Check Appropriate Box) Purpose of Building _ Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace Completion of the following table maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- 1:1No.of Emergency Lighting grind. grind. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number TonsKW No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:' No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: ,Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent i OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE ❑ BOND ❑ OTHER 0 (Specify:) !certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: WAYNE B SCHMIDT Licensee: Wayne B Schmidt Signature LIC.NO.: 33699 7f applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:222 WILLIMANTIC DR, MARSTONS MLS MA 026481929 • Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone o. PERMIT FEE:$50.00 U c3 ta/J � � f __, L) 0 cl<E4; it l.omtnonmea of% e�'7' as a< eft! Ol.�' 5If —3,-1/ 15 . r 1Jeparfmani o�-}ire�eroicee .Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked tv. 1/07) (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),..527 -MR)2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: i I ,2-.6 City or Town of: YARMOUTH To the Inspector of Wires: . By this application the undersigned gives notice of his or her intention to perform the electrical work described below. • Location(Street&Number) 35" SIV S , Owner'orTenant 3—Ck_CCI(I.p (aye Gk AS On Telephone No. Owner's Address 1 JSA-pi 1-:/f- Is Is this permit in conjunction_with a huriding permit? Yes ❑ No (Check Appropriate Box) Purpose of Building D U.] \\ Y" 3 Utility Authorization No. Existing Service__ Amps / Volts - -Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd g 0 No,of Meters Number of Feeders and Ampacity a Loadona and Nature of Proposed Electrical Work: L,1 (�o \i(� L-PfeP D } 6 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans - No.of Total Transformers KVA No.of Luminaire Outlets No.'of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting Brad. ernd. El Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches CNo.of Gas Burners�� No.of Detection and To Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers• Heat Pump I Number I Tons I KW No,of Self-Contained - • Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingMunicipal KW' Local D Connection No,of Dryers Heating Appliances KW Security Systems:• No.of WaterNo.of Devices or Equivalent Heaters KW No.of No.of Data Wiring; Signs Ballasts No.of Devices or Equivalent No.HydromassageBathtubs No.of Motors Total HP Telecommunications Wiring: - \ �;�� '�,\ No. etdces o Equivalent OTHER: \V/�\ _ Attach additional derail if desired or as required by a Inspector of Wires. Estimated Value of len 'cal Work: (When required by municipal policy.) Work to Start: 11 3 i Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless • the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE X BOND 0 OTHER$ (Specify:) (Jo('K�s Cwv'p Icerci , under t'----'--- ---_r_:—-`--_ �t WAYNE SCHMIDT 75 that the informaAtion on this /can nit true and complete. = FIRM NAME: ELECTRICIAN LW.NO.: ul Licensee: 222 WILLIMANTIC DRIVE Si Hata k cie I applicable,,enteMARSTONS MILLS,MA 026487-- g LIC.NO.: A r (508)428-7747 ne) ` Bus.Tel.No.:`jyz, 021-7/ Address. . l JJ( j *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Ait.Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally trequired by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner 0 owner's agent t Owner/Agent ' Signature Telephone No. I PERMIT FEE: $